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A doctor’s dilemma: their patients or prison

Update: July, 01/2017 - 09:00
A police investigation led to the detention of three people involved in the incident, one of which is a 31-year-old doctor named Hoàng Công Lương. He was tasked with dialysis treatment for the unfortunate patients.—Photo soha.vn

Chi Lan

The deaths of eight innocent patients in a tragic medical incident in Hòa Bình Province on May 29 dealt a severe blow to the fast-eroding public trust in the national health system. Justice must be served, and fast.

A police investigation led to the detention of three people involved in the incident, one of which is a 31-year-old doctor named Hoàng Công Lương. He was tasked with dialysis treatment for the unfortunate patients.

The charges against Lương seemed legitimate according to the law, accusing him of allowing dialysis treatment without receiving the machines’ maintenance report beforehand. A failure in the maintenance by a company contracted by the hospital turned out to be the cause of the deaths.

Lương said that he had heard the maintenance was completed beforehand, as usual, and gave the okay to run the machines.

It was uncommon, if not unprecedented, for the large community of doctors to collectively protest against the detention of one of their members.

Several medical organisations and the Ministry of Health urged the police to reconsider their decision.

They argued that Lương should not be held responsible for the quality of the machines or the drugs he used to treat the patients, saying the police should look into the maintenance company and the hospital’s leaders who signed the maintenance contract. No matter how good a doctor is, one shouldn’t assume that he also excels at fixing machines.

The second argument of the health community was far more important. Lương could have followed the correct procedures, waiting for a maintenance report before allowing dialysis to begin. This may have taken days or weeks and the patients who were desperately in need of treatment would have to wait. This sounds absurd and unethical to any doctor whose commitment is to preserving human life.

Their point was spot-on. It has revealed a common but rarely discussed dilemma for healthcare staff in Việt Nam, torn between their ethical code and all kinds of red tape and hoops they have to jump through.

It’s far from my intention to say that this paperwork is not important. In fact, it is this paperwork that ensures the quality of medical equipment used to treat people, the importance of which was painfully proven in the Hòa Binh incident. Paperwork also clarifies the responsibilities of those involved in treatment should something go wrong.

What matters here, however, is the suitability of paperwork processes for the reality of oft-overcrowded hospital workers, where doctors are pressured to treat patients as fast as they can so rooms are available for new patients.

The doctor community, well aware of a situation which the police and ordinary people have little insight into, collectively stood up to voice their sympathy for Lương. His detention, which could very well be followed by a criminal trial, would unintentionally drive doctors retreating into their protective shells. No rule breaking even in emergency or you might go to jail.

Lương’s case is a wake-up call for both the community and the Ministry of Health to reconsider the difficult situation doctors are put in every day. The grey area in their work will not go away unless the ministry draws out a realistic plan to resolve the problem, but in the meantime, a reassurance is the best we can do to help them keep doing their vital job. Laws are to be followed, but beyond that we are to seek justice. Justice for the patients and justice for the doctors too. — VNS

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